Letter to the editor regarding “Palliative Care in Acute Cardiovascular Hospitalizations: A National Inpatient Sample Analysis”

We read with great interest the recent study by McAleer et al. in which the authors analyzed the demographic, clinical, and institutional characteristics associated with palliative care (PC) use during hospitalization for acute cardiovascular disease. In their investigation, McAleer et al. extracted data from the National Inpatient Sample (NIS) and identified PC interventions by the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code Z51.5. Their results demonstrated that older age, female sex, White or Asian race, Medicare insurance, and residing in higher-income ZIP codes were associated with increased PC receipt in their adjusted model. Moreover, the highest rate of PC utilization was found among patients with cardiogenic shock by a magnitude of more than five times greater than acute myocardial infarction, acute coronary syndrome, acute heart failure, and ischemic stroke.

We commend the authors’ efforts to delineate the recent landscape of PC delivery across acute cardiovascular diseases. Identifying disparities in PC delivery is additionally critical to advancing the science and clinical impact of PC delivery for all patients. This study should, however, be interpreted considering several important limitations.

Alice Bottussi, Anne Song, Rachel Kohn, Jacopo D’Andria Ursoleo